Lottery incentives have short‐term impact on ART initiation among men: results from a randomized pilot study

作者：Ruanne V. Barnabas, Alastair van Heerden, Margaret McConnell, Adam A. Szpiro, Meighan Krows, Torin Schaafsma, Thulani Ngubane, Rose B Nxele, Philip Joseph, Jared M. Baeten, Connie Celum, Heidi van Rooyen · 发表于：Journal of the International AIDS Society · 年份：2020 · DOI：10.1002/jia2.25519 · 被引用次数：30 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、Adolescent Sexual and Reproductive Health

INTRODUCTION: Among people living with HIV in South Africa, viral suppression is lower among men than women. The study aim was to test the impact of lottery incentives, which reward positive health choice (e.g. antiretroviral therapy (ART) linkage) with a chance to win a prize, on strengthening the HIV care continuum including ART initiation and viral suppression for men. METHODS: We conducted a randomized, prospective trial of lottery incentives in the context of HIV testing and linkage to ART in rural KwaZulu-Natal, South Africa. Men living with HIV were randomly allocated to: lottery incentives and motivational text messages or motivational text messages only. Lottery prize eligibility was conditional on clinic registration, ART initiation, or viral suppression by one, three and six months respectively. After completing each continuum step, participants in the lottery group were notified whether they had won and were encouraged to continue in care. Lottery prizes were either a mobile phone, data or a gift card (valued at R1000/$100). Kaplan-Meier curves were plotted to determine time to ART initiation by study group. The primary outcome was viral suppression at six months. RESULTS: Between November 2017 and December 2018, we tested 740 men for HIV and enrolled 131 HIV-positive men who reported not being on ART. At baseline, 100 (76%) participants were 30 years and older, 95 (73%) were unemployed and the median CD4 count was 472 cells/μL. At study exit, 84% (110/131) of par...